Management of a Broken Instrument in the Middle Third of the Root Canal of a Maxillary Central Incisor-A Case Study

Abstract

Instrument separation is a recognised procedural complication during endodontic treatment and may interfere with effective cleaning, shaping, and on top of that the disinfection of the root canal, which adversely impact treatment outcomes. The management of a fractured instrument depends on several factors, including its location within the canal, root canal anatomy, accessibility of the fragment, and the amount of remaining dentine. In the present case, retrieval of the separated instrument from the middle third of the root canal was clinically challenging because adequate exposure of the fragment was required for its removal while preserving the surrounding dentine. Excessive dentine removal during retrieval could weaken the remaining root structure and increase the risk of root perforation, and subsequent root fracture. Therefore, careful assessment of the location, orientation, and accessibility of the broken instrument is essential for selecting an appropriate management approach.This case report presents the surgical management of a fractured instrument located in the middle third of the root canal of a maxillary right central incisor.